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Washington Highlights

House Appropriations Subcommittee Approves HHS Spending Bill

July 8, 2016—The House Labor-HHS Appropriations Subcommittee July 7 approved its version of the fiscal year (FY) 2017 Labor, Health and Human Services, and Education Appropriations Bill (Labor-HHS). The House Appropriations Committee is scheduled to consider the spending bill on July 13. The Senate Appropriations Committee June 9 approved its version of the FY 2017 Labor-HHS spending bill [see Washington Highlights, June 10].

According to a committee-prepared summary, the bill provides $161.6 billion in base discretionary spending, which is $569 million below the FY 2016 level and $2.8 billion below the president's budget request.

Subcommittee Chair Tom Cole (R-Okla.) noted the bill provides a $1.25 billion increase for NIH, adding that “we need to continue to build upon the $2 billion increase we provided last year.” Chairman Cole also acknowledged that the corresponding Senate bill provides a $2 billion increase for the agency in FY 2017 [see Washington Highlights, June 10], stating, “I want to be clear that I view the mark we set forth today as a floor, not a ceiling for biomedical research funding, and I am hopeful this number can increase as the process moves forward.”

Subcommittee Ranking Member Rosa DeLauro (D-Conn.) and other Democratic members voiced strong concerns for the bill. Specifically, DeLauro raised concerns over the bill’s elimination of funding for Title X Family Planning and the Teen Pregnancy Prevention program. DeLauro also raised objections that the bill “continues to prohibit funding for gun violence prevention, which has had a chilling effect on gun violence research.”

Following the subcommittee’s approval of the bill, AAMC President and CEO Darrell G. Kirch, M.D., thanked the subcommittee for recognizing the need for “sustainable, predictable growth in NIH funding ... as demonstrated by the FY 2017 bill’s $1.25 billion increase for the NIH in spite of the subcommittee’s strict budget constraints,” but added that “as lawmakers consider final funding levels, the AAMC stands ready to work with both chambers to ensure that the approved package maximizes real growth in the NIH budget.”

Of particular interest to medical schools and teaching hospitals:

NIH: The bill provides $33.3 billion for NIH in FY 2017, an increase of $1.25 billion (3.9 percent) over FY 2016. According to the committee summary, the bill includes funding for a number of initiatives within the NIH total:

$1.26 billion for Alzheimer’s disease research, an increase of $350 million over FY16;

$333.3 million for the Institutional Development Awards program, an increase of $13.5 million above FY16;

$511.5 million for the Clinical and Translational Sciences Awards program, an increase of $11.5 million above FY16;

$300 million for the Precision Medicine Initiative, an increase of $100 million over FY16;

$195 million for the BRAIN Initiative, an increase of $45 million over FY16; and

$12.6 for the Gabriella Miller “Kids First” Initiative, same as FY16 funding.

The bill retains the salary cap on extramural grants at Executive Level II ($185,100 in 2016).

Education and Labor Policy Riders: The bill includes policy riders to prevent the implementation of the Department of Education’s regulations on gainful employment and state authorization. The bill also includes a rider prohibiting enforcement of the Department of Labor’s May 18 overtime final rule [see Washington Highlights, May 20]. The Senate version does not include similar language, and Democrats and the administration are likely to oppose its inclusion.

AHRQ: The bill provides $280.2 million for the Agency for Healthcare Research and Quality (AHRQ), which is $54 million (16.2 percent) below the FY 2016 level. In the AAMC’s statement, Dr. Kirch acknowledged the association’s gratitude that the bill continues funding for AHRQ, which the House proposed terminating in FY 2016, but also expressed concern that “the steep funding cut” in the FY 2017 bill would “impede efforts across the Department of Health and Human Services to advance research that improves patient care.”

Children’s Hospitals Graduate Medical Education (CHGME): According to the committee’s summary, the bill provides $300 million for the CHGME program, which is a $5 million (1.7 percent) increase above the FY 2016 level.

Patient Center Outcomes Research Trust Fund: The House bill rescinds the entire $150 million Patient Centered Outcomes Research Trust Fund and would prohibit discretionary funds from being used to support “any patient-centered outcomes research.”

Center for Medicare and Medicaid Innovation: The bill also rescinds $7 billion from the Center for Medicare and Medicaid Innovation.

Zika funding: The bill provides $390 million through the Centers for Disease Control and Prevention (CDC) to respond to the Zika virus.